PSYCOGENIC POLYDIPSIA AND SEVERE HYPONATREMIA IN BIPOLAR AFFECTIVE DISORDER.

Psychogenic polydipsia, primary polydipsia or potomania is a disorder of multifactorial etiology which is associated with substantial morbidity and mortality. It occurs frequently in patients with psychiatric diseases, particularly those with schizophrenia, however, it is not exclusive, it has been reported in a lower proportion in patients with anxiety disorders and mood disorders. Although, is still poorly understood and therefore underdiagnosed condition.

Polidipsia psicógena e hiponatremia severa en trastorno afectivo bipolar: informe de caso / Psychogenic polydipsia and severe hyponatremia in bipolar affective disorder: case report

La polidipsia psicógena, polidipsia primaria o potomaníaes un trastorno de origen multifactorial que se asocia con unamorbilidad y mortalidad sustancial. Se presenta frecuentemente en pacientes con enfermedades psiquiátricas, particularmente aquellos con esquizofrenia, sin embargo, no es exclusiva de esta, ya que se ha notificado en menor proporción enpacientes con trastornos de ansiedad y trastornos del estadode ánimo. Peso a todo lo anterior, continúa siendo una afección poco comprendida y por ende subdiagnosticada.Es fundamental reconocer esta entidad clínica de manera oportuna, debido a sus complicaciones potencialmentegraves como la hiponatremia sintomática que puede derivaren coma y muerte si no se detecta y se maneja tempranamente. Además, se debe recalcar la importancia de una elección acertada de los psicofármacos, ya que la mayoría delos estabilizantes del afecto y algunos inhibidores selectivosde la recaptación de serotonina, pueden causar y/o agravardicho trastorno hidroelectrolítico, lo cual implica un desafíoadicional para el especialista al momento de establecer laterapia de mantenimiento.Son escasos los reportes en la literatura sobre polidipsiapsicógena documentada en trastornos del estado de ánimo,con este propósito, exponemos el caso de una paciente contrastorno afectivo bipolar que desarrolló hiponatremia severa secundaria a polidipsia primaria. (AU)

Psychogenic polydipsia, primary polydipsia or potomaniais a disorder of multifactorial etiology which is associatedwith substantial morbidity and mortality. It occurs frequently in patients with psychiatric diseases, particularly thosewith schizophrenia, however, it is not exclusive, it has beenreported in a lower proportion in patients with anxiety disorders and mood disorders. Although, is still poorly understoodand therefore underdiagnosed condition.It is essential to recognize this clinical entity opportunely,due to its potentially serious complications, such as symptomatic hyponatremia that can lead to coma and death if notdetected and managed early. Furthermore, the importanceof a correct choice of psychotropic medications should beemphasized, since most of the mood stabilizers and someselective serotonin reuptake inhibitors can cause and / oraggravate the hydroelectrolytic disorder, which implies anadditional challenge for the specialist in establishing maintenance therapy.There are few reports in the literature on documentedpsychogenic polydipsia in mood disorders, for this purpose, we present the case of a patient with bipolar affectivedisorder suffering from severe hyponatremia secondary toprimary polydipsia. (AU)